Current concepts of percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures: Evidence-based review

Hsieh, Ming‐Li; Chen, Lih-Huei; Chen, Wen-Jer

doi:10.4103/2319-4170.112544

Cited by 24 publications

(7 citation statements)

References 40 publications

(46 reference statements)

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“…As shown in Figure 6(a) and (b), although both PLLA and PLLA/C 3 S (i.e., 1% (w/w) of C 3 S in PLLA) composite membrane have similar pore diameter in average, ranging from 20 to 30 nm, the broader size distribution of PLLA matrix was observed when compared to that of PLLA/C 3 S. This was further explained by the total intrusion volume data in Figure 6(c), also called the interstitial void volume (mL/g), representing the space between packed particles [32], with the interstitial void volume of PLLA matrix decreased from 38.8 to 22.9 (mL/g) after an addition of C 3 S (1% (w/w) of C 3 S in PLLA), which is also in agreement with our previous findings that C 3 S particles added to increase the binding conditions within PLLA matrix, which makes the tighter packing of PLLA chains as well as the narrower distributions of particle sizes.…”

Section: Porosimetry Measurementsupporting

confidence: 90%

“…Osteoporosis is a bone disease with the symptoms of chronic pain in the waist or back, or neck pain due to a compression fracture, significantly affecting the life quality of the elderly [1,2]. To improve the cure rate and reduce low back pain and other symptoms of osteoporosis, percutaneous kyphoplasty (PKP) has been developed as a new treatment in which a gap was prepared in a fractured vertebral body using a balloon, followed by an injection of bone cement to restore the vertebral height [3,4].…”

Section: Introductionmentioning

confidence: 99%

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Fabrication of PLLA/C3S Composite Membrane for the Prevention of Bone Cement Leakage

et al. 2019

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Kyphoplasty is an important treatment for stabilizing spine fractures due to osteoporosis. However, leakage of polymethyl-methacrylate (PMMA) bone cement during this procedure into the spinal canal has been reported to cause many adverse effects. In this study, we prepared an implantable membrane to serve as a barrier that avoids PMMA cement leakage during kyphoplasty procedures through a hybrid composite made of poly-l-lactic acid (PLLA) and tricalcium silicate (C 3 S), with the addition of C 3 S into PLLA matrix, showing enhanced mechanical and anti-degradation properties while keeping good cytocompatibility when compared to PLLA alone and most importantly, when this material design was applied under standardized PMMA cement injection conditions, no posterior wall leakage was observed after the kyphoplasty procedure in pig lumbar vertebral bone models. Testing results assess its effectiveness for clinical practice.2 of 17 the created cavity after balloon inflation during the kyphoplasty procedure [10]. Following which the balloon is re-inserted and inflated, creating a cement shell or a cement membrane around the inner walls of the created cavity, and another batch of cement was mixed and injected into the remaining cavity thereafter with limited cement leakage possibility from initial cement setting. Although this double cement application with PMMA as the cement anti-leakage shell or membrane has demonstrated its efficacy in clinical trial during the kyphoplasty procedure [11], the long term complications might be devastating due to PMMA presence on the bone cement surface [9], which makes the development of a new material design for anti-leakage membrane necessary. For example, Tetsushi Taguchi et al. had fabricated the reactive poly(vinyl alcohol) (PVA) membrane for the prevention of bone cement leakage with good potential for implantable balloon kyphoplasty, but further investigations on its clinical efficiency are still in progress [12].On the other hand, polymeric membranes fabricated from a single material more often have limited biological performance compared to the use of hybrid biomaterials composed of biodegradable synthetic polymers and inorganic materials, with the hybrid biomaterials fitting better to bone tissue engineering applications due to their similar compositions to natural bones [13,14]. For example, biodegradable polymers such as poly(L-lactic acid) (PLLA) (L-lactic acid isomer of polylactic acid (PLA), an aliphatic thermoplastic polyester obtained by polymerizing lactide monomers) have been used for scaffold design doped with dicalcium silicate (C 2 S) nanoparticles as an ideal candidate for novel bone graft substitutes with enhanced mechanical and biodegradable properties, and biointeractive nature [15,16]. Scaffolds fabricated from (PLLA)/dicalcium phosphate dihydrate (DCPD) composite by indirect casting had also shown to effectively improve the mechanical strength and biocompatibility for the repair of bone defects when compared to the scaffold from neat PLLA [17]. From which the h...

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Section: Porosimetry Measurementsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Fabrication of PLLA/C3S Composite Membrane for the Prevention of Bone Cement Leakage

et al. 2019

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“…Significantly younger patients underwent surgical fusion (46.2 years) versus kyphoplasty (78.5 years) and vertebroplasty (76.7 years) procedures. This is consistent with an institutional study by Hsieh et al, which reported significantly older patients in their kyphoplasty versus short-segment fixation with I-VEP cohort [ 30 ]. Lad et al reported that, within their cohort of vertebral spinal fracture patients, a majority were women and over the age of 65 [ 27 ].…”

Section: Discussionsupporting

confidence: 92%

Outcomes and National Trends for the Surgical Treatment of Lumbar Spine Trauma

Drazin

Nuño

Shweikeh

et al. 2016

BioMed Research International

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Introduction. Operative treatment of lumbar spine compression fractures includes fusion and/or cement augmentation. Our aim was to evaluate postoperative differences in patients treated surgically with fusion, vertebroplasty, or kyphoplasty. Methods. The Nationwide Inpatient Sample Database search for adult vertebral compression fracture patients treated 2004–2011 identified 102,316 surgical patients: 30.6% underwent spinal fusion, 17.1% underwent kyphoplasty, and 49.9% underwent vertebroplasty. Univariate analysis of patient and hospital characteristics, by treatment, was performed. Multivariable analysis was used to determine factors associated with mortality, nonroutine discharge, complications, and patient safety. Results. Average patient age: fusion (46.2), kyphoplasty (78.5), vertebroplasty (76.7) (p < .0001). Gender, race, household income, hospital-specific characteristics, and insurance differences were found (p ≤ .001). Leading comorbidities were hypertension, osteoporosis, and diabetes. Risks for higher mortality (OR 2.0: CI: 1.6–2.5), nonroutine discharge (OR 1.6, CI: 1.6–1.7), complications (OR 1.1, CI: 1.0–1.1), and safety related events (OR 1.1, CI: 1.0–1.1) rose consistently with increasing age, particularly among fusion patients. Preexisting comorbidities and longer in-hospital length of stay were associated with increased odds of nonroutine discharge, complications, and patient safety. Conclusions. Fusion patients had higher rates of poorer outcomes compared to vertebroplasty and kyphoplasty cohorts. Mortality, nonroutine discharge, complications, and adverse events increased consistently with older age.

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“…In European Prospective Investigation into Cancer and Nutrition‐NL higher sP-selectin was linked to an increased risk of cardiovascular events ( n = 288) [7]. In persons with left ventricular ejection fraction >50%, plasma sP-selectin was shown to predict cardiac events [14]. In men at higher risk of cardiovascular disease, sP-selectin associates with the presence of carotid plaque [15].…”

Section: Introductionmentioning

confidence: 99%

Increased Soluble VCAM-1 and Normal P-Selectin in Cystic Fibrosis: a Cross-Sectional Study

Nowak

Wojsyk‐Banaszak

Mądry

et al. 2017

Lung

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PurposeAs life expectancy in cystic fibrosis (CF) increases, questions regarding its potential impact on cardiovascular health arise. Soluble vascular cell adhesion molecule 1 (sVCAM-1), P-selectin (sP-selectin) are proposed as biomarkers of cardiovascular disease. We aimed to: compare their concentrations in clinically stable CF patients and healthy subjects (HS) and verify whether they independently correlate with CF characteristics.MethodsSerum sVCAM-1 and sP-selectin levels were measured using ELISA. CF was characterized using: forced expiratory volume in 1 s, exocrine pancreatic and CF-related liver disease status, Pseudomonas aeruginosa colonization, serum high-sensitivity C-reactive protein, and body mass index (BMI). CFTR genotypes were classified as severe (classes I and II) or other.Results108 CF patients and 51 healthy subjects volunteered for the study. In the CF group BMI was lower (median [IQR]: 20.5 kg/m2 [18.4–22.2] vs. 21.6 kg/m2 [19.9–23.4], p = 0.02) and hsCRP levels were higher (3.6 mg/L [1.1–7.1] vs. 0.5 mg/dL [0.3–1.0], p < 10−10). While sVCAM-1 concentrations were greater in CF patients (1018 ng/mL [851–1279] vs. 861 ng/mL [806–979], p < 10−4), sP-selectin levels did not differ (155 ng/mL [129–188] vs. 156 ng/mL [144–177], p = 0.48). None of the multivariable regression models was valid for the prediction of sVCAM-1 and sP-selectin in CF.ConclusionsWe found higher sVCAM-1 concentrations in CF patients than in healthy subjects, which were not explained by CF characteristics. Further research is required to check whether sVCAM-1 is a marker of microangiopathy in CF.

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Current concepts of percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures: Evidence-based review

Cited by 24 publications

References 40 publications

Fabrication of PLLA/C3S Composite Membrane for the Prevention of Bone Cement Leakage

Fabrication of PLLA/C3S Composite Membrane for the Prevention of Bone Cement Leakage

Outcomes and National Trends for the Surgical Treatment of Lumbar Spine Trauma

Increased Soluble VCAM-1 and Normal P-Selectin in Cystic Fibrosis: a Cross-Sectional Study

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